甲泼尼龙琥珀酸钠联合多索茶碱治疗喘息性支气管肺炎的疗效评价

Effect Evaluation of the Efficacy of Methylprednisolone Combined with Doxorubicin in the Treatment of Asthmatic Bronchitis

目的探究甲泼尼龙琥珀酸钠(MPSS)联合多索茶碱(DOX)治疗喘息性支气管肺炎患儿的效果。方法收集洛阳景华医院2019年7月至2020年8月收治的105例喘息性支气管肺炎患儿,按治疗方案不同分成联合组(N=53)、常规组(N=52)。常规组接受DOX治疗,联合组接受MPSS联合DOX治疗。对比两组有效率、临床症状消失时间、治疗前后血清嗜酸性粒细胞趋化蛋白(Eotaxin)、白细胞介素-17(IL-17)、可溶性白细胞介素-2受体(SIL-2R)、白细胞介素-18(IL-18)、免疫功能指标[免疫球蛋白A(IgA)、IgG、IgM]水平、TLR4/NF-κB信号通路表达情况、不良反应发生率。结果联合组有效率96.23%(51/53)较常规组80.77%(42/52)高,差异有统计学意义(P<0.05);联合组喘息、咳嗽、发热、气促症状消失时间均较常规组短,差异有统计学意义(P<0.05);治疗5 d后联合组血清Eotaxin、IL-17、SIL-2R、IL-18水平较常规组低,差异有统计学意义(P<0.05);治疗5 d后联合组血清IgA、IgG、IgM水平较常规组高,差异有统计学意义(P<0.05);治疗5 d后联合组血清TLR4、NF-κB水平较常规组低,差异有统计学意义(P<0.05);联合组不良反应发生率7.55%(4/53)与常规组3.85%(2/52)对比,差异无统计学意义(P>0.05)。结论MPSS联合DOX治疗喘息性支气管肺炎患儿疗效显著,可有效减轻气道炎症、提高免疫功能,调控TLR4/NF-κB信号通路表达,促进病情恢复,且联合用药治疗安全性高。

Objective To investigate the effect of methylprednisolone combined with doxorubicin(DOX)in the treatment of asthmatic bronchitis of children.Methods A total of 105 children with asthmatic bronchitis admitted to Luoyang Jinghua Hospital from July 2019 to August 2020 were divided into combined group(N=53)and routine group(N=52)according to different treatment regimens.Conventional group received DOX,combined group received MPSS combined with DOX.The effective rate,clinical symptom disappear time,serum eosinophil chemotactic protein(Eotaxin),interleukin-17(IL-17),soluble interleukin-2 receptor(SIL-2R),interleukin-18(IL-18),level of immune function indexes(IgA,IgG,IgM),expression of TLR4/NF-κB signaling pathway and incidence of adverse reactions before and after treatment were compared between the two groups.Results The total effective rate of the combined group was 96.23%(51/53)higher than that of the conventional group 80.77%(42/52)(P<0.05);the disappearance time of wheezing,cough,fever and shortness of breath was shorter in the combined group than that of the conventional group(P<0.05);serum Eotaxin,IL-17,SIL-2R and IL-18 levels in the combined group were lower than that of the conventional group after 5 d of treatment(P<0.05);serum IgA,IgG,IgM levels in the combined group were higher than those in the conventional group after 5 d of treatment(P<0.05);serum TLR4 and NF-ºB levels in the combined group were lower than those in the conventional group after 5d of treatment(P<0.05);The incidence of adverse reactions in combination group was 7.55%(4/53)lower than that in conventional group 3.85%(2/52),and the difference was not statistically significant(P>0.05).Conclusion MPSS combined with DOX in the treatment of children with asthmatic bronchitis has significant efficacy,which can effectively reduce airway inflammation,improve immune function,regulate the expression of TLR4/NF-κB signaling pathway,and promote the recovery of the disease.Moreover,the combined treatment has high safety.